Summer Safety with William Morris, M.D.

Summer Safety with William Morris, M.D.

William Z. Morris, M.D., knows pediatric trauma and knows what it’s like to be a parent. As a pediatric orthopedic surgeon, his experience in the operating room has led him to raise awareness about some of the risks associated with lawn mowers and ATVs.
 
“I wouldn’t let my young kids use or be around a lawn mower,” says Morris. “It’s estimated that there are over 9,000 pediatric lawn mower injuries a year. One large study showed that about half of these injuries occur in kids 5 yrs of age or under. Lawn mowers can cause pretty terrible injuries that can result in amputations, most frequently in the lower extremities. In fact, around a quarter of all traumatic amputations in children are attributed to lawnmowers.

The second thing I wouldn’t let my young kids do is ride an ATV or all terrain vehicle. Injuries from ATV accidents are serious with one study showing almost 90% of kids have to get admitted to the hospital, half have some broken bone, and a quarter end up in the intensive care unit. Our general surgeon colleagues at Children’s Medical Center also recently showed that ATV injuries at our trauma center went up 77% during the COVID era, so we have unfortunately been seeing more of these injuries over the past few years.”

At any age, safety is key when using ATVs and lawn mowers. Please be careful as we head into warmer weather and outdoor activities.

Knock Knees and Bowlegs: Should You Be Concerned?

Knock Knees and Bowlegs: Should You Be Concerned?

If you notice your child’s legs curve outward at the knees or that the knees touch but the ankles are apart, your first reaction might be to worry. The good news is that knock knees and bowlegs are rarely a cause for concern, and most children with these conditions require no treatment. However, in rare cases, knock knees and bowlegs can signal a more serious condition.  

What Are Knock Knees and Bowlegs? 

When a child’s knees touch while standing up straight with their legs together, it is called knock knees, or genu valgum. This condition is common as a child grows and typically begins between ages 2 and 4. Usually, knock knees resolve on their own by the time the child is 7 or 8 years old.  

When a child’s legs curve outward while the feet and ankles are touching, it is called bowlegs, or genu varum. This condition often shows up in younger children, especially infants and toddlers. In many cases, bowlegs go away by age 3 or 4.  

Why These Leg Conditions Occur 

If you notice that your child has knock knees or bowlegs, it’s important to let your doctor know and have your child evaluated to ensure there isn’t an underlying condition. The earlier a doctor sees your child, the less likely these or any other orthopedic conditions will impact your child’s development. 

When children develop knock knees at age 4 or older, the cause might be a different health problem, such as: 

  • A healed fracture in growth plates around the knee 

  • Being overweight 

  • Dysplasia, a condition in which abnormal cells can affect bone growth 

  • Tumor in a leg bone that causes the knee to turn inward 

In rare cases, bowlegs can occur due to bone diseases, such as Blount’s disease, a growth disorder that leads to leg problems. Other conditions, such as injury or infection, can also affect how bones grow around the knees. 

Knock knees and bowlegs can also be caused by rickets, a bone growth condition resulting from a lack of vitamin D or calcium in the diet.  

Caring for Your Child’s Legs 

If your child has knock knees, your child’s doctor will closely monitor their development and help them grow correctly.  

The doctor might recommend seeing an orthopedic surgeon if: 

  • Legs don’t straighten on their own 

  • The knee on one side turns in more than on the other side 

  • Your child has a limp, pain, weakness, or trouble running 

Surgical options are available for some older children after age 10 to address these symptoms. 

If your child has bowlegs, observation and time may be the only treatments required to correct the issue. Your child may need to see a specialist if the legs are bowed differently, don’t straighten as they should, or if your child experiences discomfort, immobility or weakness. In some cases, bracing or surgery may be recommended to correct leg alignment.  

When knock knees or bowlegs happen due to rickets, treatment includes adding vitamin D and calcium to the diet or seeing an endocrinologist if a genetic condition causes the disease.  

If you have concerns about your child’s development, schedule an appointment with a lower-limb specialist at Scottish Rite for Children. 

Growing Pains: 5 Common Questions Answered

Growing Pains: 5 Common Questions Answered

If your child complains of pain in his or her legs at the end of the day, growing pains may be the cause. In most cases, these common pains are nothing to worry about. Still, understanding the possible causes and symptoms of leg pain can help you recognize when to seek medical advice. Here are answers to five common questions about growing pains to help your child get the right care. 

1. Are Growing Pains Real? 

Growing pains are a group of symptoms that commonly affect children ages 3 to 12. These symptoms are real, uncomfortable and may affect sleep. However, growing pains are not usually a reason for concern and do not cause long-term damage or issues. In some cases, though, symptoms may indicate a serious medical condition. 

2. What Are the Symptoms of Growing Pains? 

The most common symptom of growing pains is pain behind the knees, in the lower legs or in the thighs. Children feel this pain at night typically in both legs. Some children also experience abdominal pain or headaches along with leg pain. Symptoms tend to come and go over weeks or months and do not significantly affect activity. The pain usually does not occur every day and may go away for several days or weeks before returning.  

3. What Causes Growing Pains? 

Although growing pains are real, they aren’t related to growth or growth spurts. No one knows the actual root cause. However, doctors and researchers have identified several possible causes and risk factors, including: 

  • Anxiety, irritability or stress: Children with higher levels of these feelings may be more likely to experience growing pains. Having a parent with high anxiety or stress levels may also increase the risk. 

  • Decreased bone strength: Weakened bones may develop if your child does not get enough vitamin D, leading to growing pains.  

  • Foot issues: Children with feet that turn inward and have a low arch, also called flat feet, are more likely to get growing pains. 

  • Genetics: Growing pains tend to run in families. 

  • Hypermobile joints: Children who have loose joints or joints that can move past the normal range of motion have a higher risk of experiencing growing pains.  

  • Increased sensitivity to pain or outside stimulus: Some evidence suggests children who have growing pains are more sensitive to pain than others their age. Similarly, sensory processing issues may be related to growing pains. 

  • Overuse: Symptoms of growing pains are often worse after excessive physical activities. 

  • Vitamin D deficiency: Sometimes, growing pains

  • are associated with low vitamin D levels. 

Growing pains may not have a single cause. They usually develop for a combination of reasons. 

Although restless legs syndrome does not cause growing pains, symptoms of the conditions often overlap. Children with restless legs syndrome may also have a higher risk of growing pains.  

4. How Can You Help Relieve Your Child’s Symptoms? 

If your child has growing pains, there are many things you can do to reduce their pain, including: 

  • Gently stretching painful leg muscles 

  • Giving your child an over-the-counter pain reliever, such as acetaminophen 

  • Massaging the painful area 

  • Offering emotional support and letting your child know you are there for him or her 

  • Placing a heating pad or warm compress on the painful area 

  • If another underlying health condition causes growing pains, children often benefit from additional treatments, such as: 

  • A vitamin D supplement to address a deficiency 

  • Increased calcium intake to improve bone strength 

  • Mental health support to learn how to manage anxiety or stress 

  • Physical therapy for hypermobile joints 

  • Shoe orthoses for flat feet  

 5. When Should My Child Need See a Health Care Provider for Leg Pain? 

No matter the underlying cause, it’s always a good idea to talk with your child’s health care provider if he or she is experiencing new or worsening leg pain.  

Although these are not signs of growing pains, make an appointment with your child’s health care provider if he or she has one or more of the following symptoms: 

  • Leg pain accompanied by a fever, significant decrease in appetite or weight loss for no known reason 

  • Joint pain in the legs 

  • Muscle pain in the legs during exercise or in the morning 

  • Rash on one or both legs 

  • Unexplained bruising or swelling in one or both legs 

The provider can help determine the cause of growing pains, rule out other medical conditions, and suggest treatments or techniques to ease your child’s symptoms. 

​Call 214-559-8670 to schedule an appointment with a pediatric orthopedic specialist. 

Three Things to Check During Back to School

Three Things to Check During Back to School

It’s that time of year that we all know can be exciting and a little bit scary for students – back to school! As you’re getting ready to send your kids and teens off to start the new school year, it’s important to pay attention to some health and safety concerns that are easy to overlook during the hustle and bustle of getting back to school.

Backpacks:

  • It’s better for your child to carry their school supplies in a properly fitted backpack rather than a shoulder bag or messenger bag because the weight of the load is evenly distributed across the upper body.
  • Backpacks should not be too heavy. The American Academy of Pediatrics recommends that children do not carry more than 10 to 15 percent of their body weight. For example, if a child weighs 80 pounds, the backpack should not weigh more than 8 to 12 pounds.
  • Heavy backpacks do not cause scoliosis but can lead to poor posture.
  • An incorrectly worn backpack can cause shoulder, neck and back pain. When a heavy backpack is placed incorrectly on the shoulders, the force of the weight can pull a child backward or to one side, causing them to compensate in ways that can lead to pain.

Outdoor Heat:

It’s important for children and teens to know the signs and symptoms of heat illness, so they can monitor themselves.

 

Talk about the following symptoms of heat illness with your child:

  • Weakness
  • Vomiting
  • Excessive thirst
  • Headache
  • Fatigue
  • Sweating
  • Nausea
  • Light-headedness

    With a little bit of education, students and their families can enjoy a safe and happy school year!
     

    Calming Cuddles with Harry the Therapy Cat

    Calming Cuddles with Harry the Therapy Cat

    Story featured on WFAA.
    Society is often divided into two groups: dog people and cat people.

    Sometimes, people fall into both categories.

    But it can take a lot to win someone over from the other side.

    Sarah Dutton has seen it happen time after time.

    Every couple of weeks, she straps a clear, hardshell backpack with mesh sides and several air vents into Scottish Rite for Children in Dallas.

    Once inside, the precious cargo is removed, leashed, and together, they begin delivery of a dose of medicine that is as effective as it is cute and cuddly.

    “You can do anything with Harry,” Dutton said. “ You can touch his ears, you can touch his tail, you can touch his paws, even his whiskers.”

    Harry is her cat.
    She and her husband found him run over in the middle of a Denton County road.

    They nursed him back to health, and now he’s a therapy cat.
    During his twice monthly visits, Harry might sit in the lap of a child in a wheelchair or curl up in a bed beside a patient at Scottish Rite.

    Sometimes nurses or parents hold him.

    Often, they gush over him.

    “He’s the calmest cat I’ve ever seen,” laughed Sam Bryant, a certified pediatric nurse, as she held him.

    Scottish Rite is world-renowned for treating complex orthopedic conditions, especially limb differences.

    And that’s one reason Harry connects so well with this hospital’s patients.

    When Dutton’s husband found Harry, more than one veterinarian clinic said he probably needed to be euthanized.

    But the couple wasn’t convinced.

    He ended up losing a leg and shoulder to amputation. But Harry fully recovered. And as he healed, Dutton saw the potential for him to help heal others.

    “The fact that he had three legs. I felt like he could touch some people — show that you can get hurt and be disabled and be totally fine and live a normal life,” Dutton said.

    She and Harry trained through Pet Partners, completing hours of training online and in person.

    Harry’s twice a month visits to Scottish Rite are now highly anticipated by patients and staff.

    “I have a cat at home and sometimes I go home to my cat and I’m like, why can’t you be like Harry?” Bryant said. “He just stares at you with his big old eyes, and kids just love that. Even kids who aren’t cat people. He really kind of changes people’s perspectives on cats.”

    Kaliyah Brownlee got nervous the moment Harry was within view.

    “So, this is my biggest fear,” the 9-year-old said under her breath, as she was getting an infusion for Lupus treatment at Scottish Rite’s rheumatology clinic.

    Brownlee’s mother, Montranece Randall, said her daughter would normally take off running when she saw a cat.

    “She runs. We both run!” Randall said.

    In the clinic next to Brownlee was 8-year-old Virginia Chappelle.

    While Chappelle got her infusion, she was petting Harry.

    “He’s so cute,” Chappelle said. “I love his little nose.”

    And as Brownlee watched Harry work his magic on Chappelle, she gained courage.

    She wanted Dutton to bring him closer. Touching Harry soon turned into petting him. Then petting him turned into holding him.

    “I thought I was going to be scared, but I’m not scared of cats anymore!” she said. 

    “I think we should get one,” she told her mom – who also pet Harry.

    Harry might not be the kind of medicine doctors prescribe, but the special connection he makes with patients is its own kind of cure.

    I feel like he understands a lot of people’s emotions and what they need,” said Dutton.

    Read the entire article.

    Pediatric Musculoskeletal Ultrasound at Scottish Rite for Children

    Pediatric Musculoskeletal Ultrasound at Scottish Rite for Children

    Pediatric musculoskeletal (MSK) ultrasound is a safe, effective, and painless approach to observing bones, ligaments, tendons, and other tissues in and around joints. At Scottish Rite for Children, ultrasound has been used for many years by our radiologists and ultrasound technologists when diagnosing infantile hip dysplasia and other conditions; however, the possibilities and indications to use ultrasound for other musculoskeletal conditions are increasing. This includes using it with young athletes to better visualize the structure and function of these different tissues.

    Many soft tissue conditions and concerns on the surfaces of bones can be diagnosed with ultrasound. Because children have immature bones with areas of soft cartilage, they have unique conditions around the bones and joints that can also be evaluated with ultrasound. Additionally, providing treatments with needles, such as joint aspirations and injections, can be enhanced when ultrasound is available.

    In two specific areas of our organization, ultrasound is used by providers at the bedside during an evaluation or procedure. This is called point-of-care ultrasound (POCUS) and is a way to combine the clinical history and exam with the findings of the ultrasound. For a provider to use this tool, extensive training and many hours of experience are necessary. Pediatric rheumatology nurse practitioner Heather Benham, D.N.P., APRN, CPNP-PC, and sports medicine physician Jacob C. Jones, M.D., RMSK, have met and exceeded those qualifications.

    With their extensive experience, they are also equipped to teach others how to use this tool with a younger population. Many programs available are focused on the assessment of soft tissues in a population that is older. Benham and Jones worked together to create the Scottish Rite for Children Pediatric Musculoskeletal Ultrasound Fundamentals Course (PMSKUS). Along with course co-director Vivek Kalia, M.D., M.P.H., M.S., they hosted the inaugural event in November 2022. The next opportunity to take this one-day course will be in May 2023 at the Scottish Rite for Children Orthopedic & Sports Medicine Center in Frisco.

    Learn more.